Abstract
Background: Physical exercises are well known to be an important part of comprehensive cardiac rehabilitation(CR), but many protocols of physical exercises are not applicable for the old patients for many reasons. Purpose: To study the possibility of respiratory muscles trainings (RMT) in old patients with heart failure (HF) as a way of physical rehabilitation. Methods: 57 patients 84,4±5,7 years old with NYHA II- III HF were randomized to either an exercise training group (EG)(29pts) or to a control group (CG). The CG patients had standard CR according to the national guidelines. The EG participated additionally in a RMT with gradual increase of inspire and expire resistance. Trainings were held for 20 minutes twice a day for 12 months. Peak oxygen consumption (VO2peak) during 6 minute walking test (6 MWT), maximal inspiratory mouth pressures (PI max) were measured at baseline and in 12 months. Results: After 12 weeks there was significant increase in results of 6 MWT in EG (299,6±19,37 m in EG vs 298,2±18,12 m in CG at baseline, [[Unable to Display Character: &#1088;]]>0,05; after (12 months 342±12,76m vs 297,3±11,85 m [[Unable to Display Character: &#1088;]]<0,05), VO2peak in EG 14,96±1,84ml/kg/min in EG vs 14,99±1,91 ml/kg/min in CG at baseline, [[Unable to Display Character: &#1088;]]>0,05; after 12 months 16,18±1,46 ml/kg/min vs 14,35±1,11 ml/kg/min, [[Unable to Display Character: &#1088;]]<0,01) and PImax in EG (median PI max, 6,4 in both groups [25th-75th percentile range 6,4-6.9 in EG vs 25th-75th percentile range 6,3-6,9 in CG] at baseline, p=0,7), after 12 months EG median PI max, 6,9 in EG [25th-75th percentile range6,9-7,2] vs median PI max, 6,5 [25th-75th percentile range 6,3-6,5] in CG, [[Unable to Display Character: &#1088;]]<0,01). EG patients had significantly less hospitalizations because of HF progression (16,9% in EG vs 27,5% in CG) and pneumonias (14,1% vs 19.3%). There were 7 lethal outcomes in EG vs 12 in CG. Conclusion: RMT in old patients with HF improves physical capacity, maximal inspiratory mouth pressures, e and decrease the number of hospitalizations because of HF progression and pneumonias
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